How To Not Generate New Customer Leads

Stethoscope on 100 dollar bills symbolizing financial surveillance

Tanya Parrish Grant, 51, was a business owner of two health care companies in North Carolina that provided durable medical equipment (DME) such as back, shoulder, knee, and wrist braces to Medicare patients. Between both companies, Atlantic Brace and Blue File they generated claims to bill Medicare for more than $50 Million between 2014 and 2021. Business was good for Grant, but it turns out those patients weren’t real. On July 1, 2022, Grant pleaded guilty to Medicare fraud in stealing more than $17 million from the U.S. government.

The investigation showed that to generate revenues, Grant paid companies in India and Pakistan to provide her with lists of Medicare patient names and identifying information. These lists of patients were supposedly derived from overseas call centers that contacted Medicare patients to inquire about their need for DME. Grant then directed her companies to bill Medicare for DME that she supposedly supplied to the patients.

While U.S. Federal law requires written physician orders to support claims, for Grant and the companies that she owned, evidence showed that this was not the case. In many instances, Grant billed Medicare without supporting physician orders, and without shipping products.  Even when patients received the equipment in the mail and then returned the equipment, Grant did not reimburse Medicare for the returned equipment.

Grant could have demanded her money back for the poor quality of lists from the overseas call centers. Investigators found that 422 of the Medicare claims were in the names of deceased individuals. This, however, this did not stop Grant from mailing them knee braces.

Grant faces up to 10 years in prison when she is sentenced later this year.

Great job by the U.S.  Department of Health and Human Services and the FBI who investigated this case.

Today’s “Fraud of the Day” is based on an article posted by Raleigh News & Observer, on July 6, 2022

North Carolina woman Pleads Guilty to Healthcare Fraud

RALEIGH, NC (AP) — A North Carolina woman who controlled two healthcare companies pleaded guilty Wednesday to charges resulting from a scheme in which she collected $17 million after the companies billed Medicare for medical equipment it never delivered.

U.S. Attorney Michael Easley says Tanya Parrish Grant of Raleigh carried out her scheme between 2017 and 2021 through her companies, which provided back, shoulder, knee, and wrist braces and other equipment to Medicare beneficiaries.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.